Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Mar 2013
ReviewCranial base repair with combined vascularized nasal septal flap and autologous tissue graft following expanded endonasal endoscopic neurosurgery.
The expanded endonasal endoscopic approach provides excellent visualization and access to midline skull base lesions, albeit with a relatively high risk of postoperative cerebrospinal fluid (CSF) leakage. We present our experience with the expanded endonasal endoscopic approach to the skull base in an institution where, previously, a traditional transsphenoidal approach with a surgical microscope had been used. ⋯ The repair of skull base defects created during expanded endonasal endoscopic surgery is improved by use of a mucoperichondrial nasal septal flap combined with a layered autologous tissue graft. When CSF leakage occurs despite nasal septal flap closure, the site of the leakage may be easier to localize and repair.
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J Neurol Surg A Cent Eur Neurosurg · Mar 2013
Endoscopic interlaminar management of lumbar disc disease.
The role of surgery by minimally invasive techniques for lumbar disc disease remains unclear in the Cochrane review. There are reports of significant advantages of endoscopy over open or microdiscectomy techniques, such as better visualization of the lesion, smaller incision sizes with lower short-term morbidity, reduced hospital stay, and better education. ⋯ Endoscopic interlaminar technique (ILT) was a safe and effective alternative procedure for lumber disc disease. This was associated with some complications, especially in the initial learning curve. Once the practitioner is over the learning curve and has acquired expertise, this procedure was safe and effective.